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Hearing identification in difficult-to-test children. A study of 142 infants and children
1Department of Otorhinolaryngology, University of Tromsø, Norway.
Insights
Parental hearing opinions in children can be inaccurate, with many false negatives. Auditory brainstem response (ABR) testing is crucial for reliable hearing loss diagnosis in difficult-to-test children.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Clinical Diagnostics
Background:
- Accurate hearing assessment in 'difficult-to-test' children is challenging.
- Behavioral auditory tests and parental opinions have limitations in diagnosing hearing loss.
- Early identification of hearing impairment is critical for child development.
Purpose of the Study:
- To evaluate the accuracy of parental hearing opinions in children.
- To assess the reliability of behavioral auditory tests compared to Auditory Brainstem Response (ABR).
- To identify factors influencing diagnostic delay in pediatric hearing loss.
Main Methods:
- Retrospective analysis of case records from 142 'difficult-to-test' children undergoing ABR.
- Comparison of ABR thresholds with parental opinions and results from behavioral auditory tests.
- Evaluation of false-negative rates in parental hearing assessments.
Main Results:
- Parental opinion showed a high rate of false-negatives (29%) for hearing loss.
- Behavioral auditory tests had poor reliability in children with normal hearing.
- Agreement between ABR and behavioral tests exceeded 70% in hearing-impaired children.
Conclusions:
- Parental perception of hearing is not always reliable for diagnosing hearing loss in children.
- Auditory Brainstem Response (ABR) provides a more reliable threshold determination.
- Minimizing diagnostic delay through accurate testing is essential for effective intervention.
Abstract:
Prior to auditory brainstem response (ABR) threshold determinations in 142 anaesthetized 'difficult-to-test' children, 125 had one or more behavioural auditory tests performed. We used the ABR thresholds as a basis and retrospectively analysed the case records in relation to some parental and behavioural auditory aspects. The accuracy of the parental opinion regarding hearing has been evaluated, and showed a relatively high rate of false-negatives (29%). In contrast, the presence of a hearing loss was correctly identified in 53%. The reliability of one or more standard behavioural auditory tests was poor in children with normal hearing, but in hearing impaired, there was agreement between ABR and behavioural results in more than 70% of cases. Median age at the ABR examination was 32 months. These and other results are discussed in view of the need to minimize diagnostic delay.